KAJIAN LITERATUR: POLA PENGGUNAAN ANTIBIOTIK PROFILAKSIS PADA PASIEN DENGAN PERSALINAN SECTIO CAESAREA

Nanda Nur Maulidya(1), Rika Yulia(2), Fauna Herawati(3*)

(1) Mahasiswa Fakultas Farmasi, Universitas Surabaya
(2) Departemen Farmasi Klinis-Komunitas, Fakultas Farmasi, Universitas Surabaya.
(3) Departemen Farmasi Klinis-Komunitas, Fakultas Farmasi, Universitas Surabaya.
(*) Corresponding Author

Abstract

ABSTRAK

               Sectio caesarea atau bedah sesar merupakan prosedur pembedahan untuk kelahiran janin melalui insisi pada dinding abdomen dan uterus. Sectio caesarea merupakan salah satu prosedur bedah yang memerlukan antibiotik profilaksis dalam pelaksanaannya. Penelitian ini bertujuan untuk mereview kejadian infeksi luka operasi dan profil penggunaan antibiotik profilaksis pada pasien sectio caesarea. Metode yang digunakan pada penelitian ini merupakan kajian literatur atau sistematik review yang menggunakan desain penelitian Randomized Controlled Trial dengan terbitan publikasi tahun 2011-2020. Didapatkan sebanyak 18 artikel yang digunakan sebagai sampel penelitian. Berdasarkan hasil sintesis data, antibiotik golongan sefalosporin yaitu cefazolin merupakan antibiotik yang paling sering digunakan pada pasien yang menjalani sectio caesarea elektif, sedangkan untuk sectio caesarea darurat antibiotik yang paling sering digunakan adalah golongan makrolida yaitu azitromisin. Dari 18 artikel penelitian terebut, dilihat juga kesesuaian jenis dan dosis antibiotik terhadap guideline ASHP dan WHO. Antibiotik profilaksis efektif dalam menurunkan risiko kejadian demam, infeksi luka operasi, infeksi saluran kemih, dan endometritis. Waktu pemberian antibiotik baik sebelum sayatan kulit maupun sesudah penjepitan tali pusat tidak berbeda signifikan terhadap outcome yang terjadi. Berdasarkan hasil penelitian, disimpulkan bahwa penggunaan antibiotik profilaksis pada pasien sectio caesarea elektif sudah sesuai dengan rekomendasi pada guideline yaitu menggunakan antibiotik sefazolin, sedangkan pada pasien sectio caesarea darurat belum sesuai karena menggunakan antibiotik azitromisin.

Kata Kunci: Antibiotik profilaksis, bedah sesar, infeksi luka operasi

ABSTRACT

Caesarean section or sectio caesarea is a surgical procedure for the delivery of the fetus through an incision in the abdominal wall and uterus. Sectio caesarea is a surgical procedure that requires prophylactic antibiotics in its implementation. This study aims to review the incidence of surgical wound infection and the profile of the use of prophylactic antibiotics in sectio caesarean patients. The method used in this study is a literature review or systematic review using the Randomized Controlled Trial research design with publications in 2011-2020. There were 18 articles used as research samples. Based on the results of data synthesis, the cephalosporin class of antibiotics, namely cefazolin, is the most commonly used antibiotic in patients undergoing elective caesarean section, while for emergency cesarean sections, the most commonly used antibiotic is the macrolide group, azithromycin. Of the 18 research articles, it was also seen the suitability of the types and doses of antibiotics against the ASHP and WHO guidelines. Prophylactic antibiotics are effective in reducing the risk of fever, surgical wound infections, urinary tract infections, and endometritis. The time of giving antibiotics both before the skin incision and after the clamping of the umbilical cord was not significantly different from the outcome. Based on the results of the study, it was concluded that the use of prophylactic antibiotics in elective cesarean section patients was in accordance with the recommendations in the guidelines, namely using the antibiotic cefazolin, while in emergency cesarean section patients it was not appropriate because the antibiotic azithromycin was used.

Keywords: Antibiotic prophylactic, sectio caesarea, surgical site infection

References

American Society of Health-Systems Pharmacists. 2013. Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery. Am J Hosp Pharm. 50. Pp: 305-14.

Bhattacharjee, N., Saha, S. P., Patra, K. K., Mitra, U., and Ghoshroy, S. C. 2013. Optimal timing of prophylactic antibiotic for cesarean delivery : A randomized comparative study. 39(12). Pp:1560–8. https://doi.org/10.1111/jog.12102

Crader, M. F., and Varacallo, M. 2020. Preoperative Antibiotic Prophylaxis. Medscape [Internet] 2020 [Cited 2020 March 30]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK442032/

Dlamini, L. D., Sekikubo, M., Tumukunde, J., Kojjo, C., Ocen, D., Wabule, A., and Kwizera, A. 2015. Antibiotic prophylaxis for caesarean section at a Ugandan hospital: A randomised clinical trial evaluating the effect of administration time on the incidence of postoperative infections. BMC Pregnancy and Childbirth. 15(1). Pp: 1–7. https://doi.org/10.1186/s12884-015-0514-3

Francis, C., Mumford, M., Strand, M. L., Moore, E. S., and Strand, E. A. 2013. Timing of prophylactic antibiotic at cesarean section: A double-blinded, randomized trial. Valent. Journal of Perinatology, 33(10), 759–762. https://doi.org/10.1038/jp.2013.56

Herawati, F., Rahem, A., Handayani, D. W. I., dan Yulia, R. 2018. Antibiotic prophylactics on curettage for preventing pelvic inflammatory disease events: Is it necessary? Asian Journal of Pharmaceutical and Clinical Research. 11(11). Pp: 267–9. https://doi.org/10.22159/ajpcr.2018.v11i11.27817

Hong, F., Zhang, L., Zhang, Y., Sun, W., Hong, H., and Xu, Y. 2016. Antibiotic prophylaxis to prevent postoperative infectious morbidity in low-risk elective cesarean deliveries: A prospective randomized clinical trial. Journal of Maternal-Fetal and Neonatal Medicine. 29(9). Pp: 1382–6. https://doi.org/10.3109/14767058.2015.1052397

Husnawati, H. dan Wandasari, F. 2014. Pola Penggunaan Antibiotik Profilaksis pada Pasien Bedah Caesar (Sectio Caesarea) di Rumah Sakit Pekanbaru Medical Center (PMC) Tahun 2014. Jurnal Sains Farmasi & Klinis, 2(2), 303-307.

Ierano, C., Manski-Nankervis, J. A., James, R., Rajkhowa, A., Peel, T., and Thursky, K. 2017. Surgical antimicrobial prophylaxis. Australian Prescriber, 40(6), 225–229. https://doi.org/10.18773/austprescr.2017.073

Jyothirmayi, C. A., Halder, A., Yadav, B., Samuel, S. T., Kuruvilla, A., and Jose, R. 2017. A randomized controlled double blind trial comparing the effects of the prophylactic antibiotic, Cefazolin, administered at caesarean delivery at two different timings (before skin incision and after cord clamping) on both the mother and newborn. BMC Pregnancy and Childbirth, 17(1), 1–8. https://doi.org/10.1186/s12884-017-1526-y

Kalaranjini, S., Veena, P., and Rani, R. 2013. Comparison of administration of single dose ceftriaxone for elective caesarean section before skin incision and after cord clamping in preventing post-operative infectious morbidity. Archives of Gynecology and Obstetrics. 288(6). Pp:1263–8. https://doi.org/10.1007/s00404-013-2906-9

Kandil, M., Sanad, Z., and Gaber, W. 2014. Antibiotic prophylaxis at elective cesarean section: A randomized controlled trial in a low resource setting. Journal of Maternal-Fetal and Neonatal Medicine. 27(6). Pp: 588–91. https://doi.org/10.3109/14767058.2013.823938

Kementerian Kesehatan RI. 2015. Peraturan Menteri Kesehatan nomor 8 tahun 2015. Pedoman Pencegaha Dan Pengendalian Resistensi Antimikroba, 334, 1–31.

Lyimo, F. M., Massinde, A. N., Kidenya, B. R., Konje, E. T., & Mshana, S. E. 2013. Single dose of gentamicin in combination with metronidazole versus multiple doses for prevention of post-caesarean infection at Bugando Medical Centre in Mwanza, Tanzania: A randomized, equivalence, controlled trial. BMC Pregnancy and Childbirth. 13. https://doi.org/10.1186/1471-2393-13-123

MacOnes, G. A., Cleary, K. L., Parry, S., Stamilio, D. M., Cahill, A. G., Odibo, A. O., & Rampersad, R. 2012. The timing of antibiotics at cesarean: A randomized controlled trial: Editorial Comment. Obstetrical and Gynecological Survey. 67(8). Pp: 453-4. https://doi.org/10.1097/01.ogx.0000419555.26591.4e

Mivumbi, V. N., Little, S. E., Rulisa, S., and Greenberg, J. A. 2014. Prophylactic ampicillin versus cefazolin for the prevention of post-cesarean infectious morbidity in Rwanda. International Journal of Gynecology and Obstetrics. 124(3). Pp: 244–7. https://doi.org/10.1016/j.ijgo.2013.09.017

Mohammed, S. O., Shuaibu, S. D. A., Gaya, S. A., and Rabiu, A. 2020. The efficacy of two doses versus 7 days’ course of prophylactic antibiotics following cesarean section: An experience from Aminu Kano Teaching Hospital. Annals of African Medicine. https://doi.org/10.4103/aam.aam_39_19

Osman, B., Abbas, A., Ahmed, M. A., Abubaker, M. S., and Adam, I. 2013. Prophylactic ceftizoxime for elective cesarean delivery at Soba Hospital, Sudan. BMC Research Notes. 6(1). Pp: 0–4. https://doi.org/10.1186/1756-0500-6-57

Prasetya, D. B. 2013. Efektifitas Penggunaan Antibiotik Pada Pasien Seksio Sesarea Elektif Di Rumah Sakit X Sidoarjo. Jurnal Ilmiah Mahasiswa Universitas Surabaya. 2(2). Pp: 1–10.

Rivai, F., Koentjoro, T., dan Utarini, A. 2013. Determinan Infeksi Luka Operasi Pascabedah Sesar. Kesmas: National Public Health Journal. 8(5). P: 235. https://doi.org/10.21109/kesmas.v8i5.390

Tita AT, Szychowski JM, Boggess K, Saade G, Longo S, Clark E, Esplin S, Cleary K, Wapner R, Letson K, Owens M, Abramovici A, Ambalavanan N, Cutter G, and Andrews, W. 2016. Adjunctive azithromycin prophylaxis for cesarean delivery. N Engl J Med. 375(13). Pp: 1231–41. https://doi.org/10.1056/NEJMoa1602044

Valent, A. M., Dearmond, C., Houston, J. M., Reddy, S., Masters, H. R., Gold, A., and Warshak, C. R. 2017. Effect of post–cesarean delivery oral cephalexin and metronidazole on surgical site infection among obese women: A randomized clinical trial. JAMA - Journal of the American Medical Association. 318(11), Pp: 1026–34. https://doi.org/10.1001/jama.2017.10567

Westen, E.H., Kolk, P.R., van Velzen, C.L., Unkels, R., Mmuni, N.S., Hamisi, A.D., Nakua, R.E., Vlek, A.L., and van Beekhuizen, H.J. 2015. Single-dose compared with multiple day antibiotic prophylaxis for cesarean section in low-resource settings, a randomized controlled, noninferiority trial. Acta Obstet Gynecol Scand. 94(1). Pp: 43–9. https://doi.org/10.1111/aogs.12517

World Health Organization. 2019. The selection and use of essential medicines. World Health Organization technical report series, (965).

Witt, A. 2011. Antibiotic Prophylaxis Before Surgery vs After Cord Clamping in Elective Cesarean Delivery. Archives of Surgery. 146(12). P:1404. https://doi.org/10.1001/archsurg.2011.725

Yulia, R., Herawati, F., dan Anggraini, W. 2018. Evaluation of Antibiotics Use and Bacteria Profile of Caesarean Section at Regional General Hospital, Pasuruan. Indonesian Journal of Clinical Pharmacy. 7(2). Pp: 69–77. https://doi.org/10.15416/ijcp.2018.7.2.69

Zhang C, Zhang L, Liu X, Zhang L, Zeng Z, Li L, Liu G, and Jiang, H. 2015. Timing of antibiotic prophylaxis in elective caesarean delivery: A multi-center randomized controlled trial and meta- Analysis. PLoS One. 10(7). Pp: 1–15. https://doi.org/10.1371/journal.pone.0129434

Ziogos, E., Tsiodras, S., Matalliotakis, I., Giamarellou, H., and Kanellakopoulou, K. 2010. Ampicillin/Sulbactam versus Cefuroxime as antimicrobial prophylaxis for cesarean delivery: A randomized study. BMC Infectious Diseases. 10. https://doi.org/10.1186/1471-2334-10-34

DOI: 10.23917/biomedika.v14i1.13632

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